Trans Rectal Ultrasound and Prostate Biopsy

Prostate biopsy is a safe and effective sampling technique during which tissue is obtained from the prostate gland for the purpose of detecting cancer.

Trans rectal ultrasound guided biopsy is the preferred approach in most cases. It involves the examination of the prostate by an ultrasound probe inserted into the rectum. After local anaesthetic has been injected, a fine needle is inserted into the prostate and a number of small samples (biopsies) are taken.

Allow a total appointment time of 30 minutes, although the procedure itself normally takes 5-10 minutes.

Before the procedure

  • Do not take aspirin or anti-inflammatory medications for 7 days before the procedure. This will reduce the risk of bleeding.
  • Please advise your doctor if you are taking Warfarin or any blood thinners as he will need to discuss this with you.
  • A single antibiotic tablet (Ciproxin) is used before and after the procedure to significantly diminish the risk of infection.
  • A microlax enema may be used prior to the procedure if ordered by your doctor.
  • Antibiotic (Ciproxin) Tablets
  • In line with infection control guidelines, we recommend antibiotic treatment to minimise the risk of infection.
  • You will be supplied with two antibiotic tablets.
  • The first tablet should be taken one and a half hours (90 minutes) before your appointment. You should have nothing to eat for two hours before and after your tablet. You may drink water if you are thirsty.
  • Take your second antibiotic tablet approximately two hours following your evening meal. After your meal only drink water if you are thirsty.

During the procedure

  • You will be escorted to theatre and asked to change.
  • The procedure is carried out with you lying on your left side in a similar position to a rectal examination.
  • The ultrasound probe is inserted into your rectum.
  • Local anaesthetic is injected around the prostate to make the biopsies more comfortable.
  • The biopsy samples are obtained by a biopsy needle.
  • It is important to lie as still as possible and let the doctor know if the procedure is painful.

After the procedure

  • The biopsy specimens are sent to the Pathologist for examination.
  • A sick certificate and follow-up appointment will be arranged as requested by your doctor.
  • Limit your activities and rest for 24 hours.
  • You should be able to resume normal activities the following day.

Risks and complications

Infection

If you feel unwell with a headache, sweating, fevers, chills, painful testicles or problems passing urine, you need to contact your Urologist immediately as you may require admission to hospital for further treatment.

Bleeding

You may experience blood in your urine, bowel motion and semen and this will gradually subside over the next 2 weeks and rarely causes a problem. If bleeding persists or is very heavy, contact your doctor.

Inability to urinate

This can occur due to swelling around the prostate and may rarely lead to a complete blockage of urine flow. If this occurs, contact your doctor.

Pain and discomfort

You may experience discomfort in the rectum or base of the penis. This is very common and should settle within 24-48 hours.